Dentistry and Core Values

The concept of dentistry and core values was formally presented to me in 2004, while progressing through the continuum at the L.D. Pankey Intitute, examining how core values affected my staff, my patients and me.  I had some ideas about core values, but had never seen a list or completed any work around a values inventory or clarification.  My assumption was that we should all have the same core values, such as honesty and integrity.  I was amazed and confused by the list and how many of the values I had never heard or clearly appreciate their definitions.

Not only do they have a direct effect on how I work and interact with others, but knowing my core values makes my understanding of myself, others and interactions with others more impactful.  Regularly reviewing my values as I have integrated teaching them to others has allowed me an opportunity to experience how they have changed in the last 11 years and wonder how they will change as I continue to mature.  These experiences have also given me the gift of understanding that all of the values are good and justifiable, but there is inherent conflict when one person's values are not congruent with another's. 

My current top three values from the 2004 list are as follows

1. Emotional well-being: Defined by “freedom from overwhelming anxieties and barriers to effective functioning; peace of mind, inner security.” 
2. Health: Defined by “the condition of being sound in body; freedom from disease or pain, the general condition of the body; well-being.” 
3. Recognition: Defined by “being able to feel significant and important; being given special notice or attention.” 

In private practice, formal dental education and post-graduate teaching, these values seem to be in obvious conflict with my work.  Emotional well-being is constantly challenged in the first two settings due to the inherent lack of predictability and stressful environment.  Being the “CEO” of a small company (private dental practice), manager of employees, and producing technical high-level dentistry, while dealing with the behavioral side of the actual dentistry certainly is not conducive to emotional well-being.  

Health, the second value, can be difficult to support due to stress and time commitments. And it seems somewhat hypocritical for a value as we preach health to our staff and patients if we do not practice good health.  For me, health and emotional well-being are almost synonymous.  My emotional well-being is quite dependent on my health and making the time for health. 

Recognition is also a difficult value in dentistry and dental education.  Patients cannot see all of our hard work and recognize our skills. Similarly, in private practice there is little recognition from our colleagues, as we are very isolated in our own practices.  In dental school, there are many great instructors doing many wonderful things.  As with all job satisfaction surveys, recognition is important but can be difficult in a university setting.  Interestingly, as I have continued increasing my knowledge, skills and influence in post-graduate teaching, my core values seem to be better supported.  This type of teaching is very predictable, makes me happy, allows me time to be healthy, and if done well, allows me very positive recognition. 

In a different list of core values, my values in the work environment in ranked order

1. Personal growth
2. Prestige
3. Friendship

Similar to the negative correlation with my profession in private practice and the values from the first inventory, these three values are also not conducive to their mutual support.  Owning a private practice can be somewhat counterproductive to personal growth, prestige and friendships.  An interesting difference between the two sets of values is that teaching at the dental school, taking on a role as course director, a position on the admissions committee and engaging in other university activities is an advantageous setting for all three values.   Post-graduate teaching, such as Spear Education and working with other dentists is also a supportive setting for these three values.

I can imagine a dentist whose top core values might be autonomy, power and precision and how one could make a case that his work might be more satisfying than mine. I also know that there are so many gifts that I bring to each setting with my core values and how they can be a positive influence on others and on the work environment as a whole.  As I influence or adjust my office schedule for emotional well-being and I schedule time for health, the work environment for others becomes more calming and under control.  Our message promoting health also seems more congruent with our conversations with our patients and supporting each other in health, as well.  As I strive for recognition, my hope is that it would lead me towards positive recognition, not negative; therefore, my continued drive for clinical, behavioral and teaching excellence has and will continue to have a positive influence on others.  With respect to personal growth, prestige and friendship, I think those values also support a respectful, intellectual and collegial work environment and have a positive influence on others.

As I have become more aware of my values and the impact they have on me, and others, I have become passionate about sharing my knowledge with dental students, dentists and faculty.  The unexpected gift for me is to see that although our top five or ten values remain, the values that drive us or influence us most change over time, or shuffle regularly.  What might have been important to us early in life and in career changes over time.  As we have more life experiences, grow intellectually and gain true wisdom, a value that may have been less motivating or inspiring earlier guides our thoughts and becomes more influential in our decisions and actions.  I can imagine that if wealth, achievement, prestige or power were core values early in life, then love, health, friendship, social service or autonomy might move towards the top of the rankings later in our careers/lives.  As I see this in myself, and my mentors, I appreciate how we can have a positive influence on others in work and life and leave a legacy from which others can learn and grow.

One of the greatest gifts that an understanding of core values has given me is the appreciation for all core values and how each individual's values should be supported but at the same time can be in conflict with ours.  I feel that at the center of many conflicts is the natural defense of our values.  The irony, I think, is that all core values are good but that as we support our values and defend them, some of the most emotional and confrontational arguments and battles stem from core values.  One individual's values might be achievement, advancement and activity, which are very commendable and understandable values.  A colleague might have autonomy, creativity and flexibility as his or her top values.  If these two people worked closely, whether in proximity or job description, it is obvious how they could be in conflict with each other.  Again, all six values are worthy and defendable.  The benefit of identifying my own values and identifying others’ values through intentional conversation is the gift of perspective.  I can support my values while appreciating and respecting “those other people.”  When I see or feel emotions heightening, I can almost always identify a conflict of values.  This is beneficial both personally and at work, not only for me but to bring perspective to others, if appropriate.  I think that an understanding of core values is an integral part of facilitating, especially in the healthcare industry.

As I have only started to understand core values and their impact on human nature, I have grown to appreciate the impact they have on me in my personal and professional life.  In fact, the more I have learned, the more congruent my life has become.  I consider that a gift that I hope will continue to grow.  I also think that a better understanding of how values affect our relationships can only help connect us all on a more human level.  Moreover, the gift of understanding that our values might change over time and allowing them to change might actually be the true gift of wisdom and the positive legacy we leave for others as we lead by example.

So, what are your core values? Share them in the comments!

Kevin Kwiecien, D.M.D., M.S., Spear Faculty and Contributing Author